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Prospective association between food protein-induced allergic proctocolitis in infancy and constipation after age 3
Michael Marget1,2, Corey Baker3, Isabel O'Connell1,2
1Food Allergy Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
Insights
Infant food protein-induced allergic proctocolitis (FPIAP) is linked to a higher risk of developing constipation in childhood. This study suggests a potential connection between early allergic reactions and later gastrointestinal issues.
Area of Science:
- Pediatric Gastroenterology
- Allergy Immunology
- Microbiome Research
Background:
- Food protein-induced allergic proctocolitis (FPIAP) is an allergic condition in infants.
- Constipation is a common pediatric gastrointestinal issue.
- The long-term effects of FPIAP on childhood gut health are not fully understood.
Purpose of the Study:
- To prospectively investigate the association between FPIAP in infancy and the development of constipation later in childhood.
- To explore potential shared underlying mechanisms, such as visceral hypersensitivity or intestinal dysbiosis.
Main Methods:
- Utilized the Gastrointestinal Microbiome and Allergic Proctocolitis (GMAP) cohort data.
- Reviewed medical charts of 375 children with prospective parent-reported constipation after age 3.
- Confirmed FPIAP diagnosis based on pediatrician assessment and presence of bloody stools.
Main Results:
- Children with a history of FPIAP had over double the odds of developing constipation after age 3 (OR: 2.62, p=0.002).
- The incidence of stimulant laxative use was significantly higher in children with FPIAP (OR: 4.68, p=0.01).
Conclusions:
- FPIAP during infancy is prospectively associated with an increased risk of constipation in later childhood.
- This association may indicate shared underlying pathogenesis, potentially involving heightened visceral hypersensitivity or intestinal dysbiosis.
- Further research is warranted to elucidate the mechanisms connecting FPIAP and childhood constipation.
Abstract:
We sought to prospectively evaluate whether food protein-induced allergic proctocolitis (FPIAP) during infancy is associated with increased constipation later in childhood. Using the Gastrointestinal Microbiome and Allergic Proctocolitis (GMAP) cohort, we reviewed charts of children with prospective parent-reported constipation after age 3 to confirm the diagnosis of constipation. A diagnosis of FPIAP was based on pediatrician diagnosis and required guaiac-positive or grossly bloody stools, as previously published. Three hundred and seventy-five subjects had sufficient data for these analyses. Subjects with FPIAP had more than two times the odds of developing constipation after age 3 compared to subjects without (odds ratio [OR]: 2.62, 95% confidence interval [CI]: [1.42-4.74], p = 0.002). The use of stimulant laxatives was also higher in children with FPIAP (OR: 4.68, 95% CI: [1.47-16.04], p = 0.01). FPIAP was prospectively associated with the later development of constipation after age 3. This may suggest shared underlying pathogenesis, resultant heightened visceral hypersensitivity, and/or intestinal dysbiosis, all warranting further study.
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